Proficient clinical/manual breast examination (CBE) is an effective and accepted breast cancer screening tool that remains inaccessible to a large population of women with physical disabilities. There are no standards for training clinicians to conduct CBE with this population of women and few resources for screening them. This research project is designed to investigate and validate the elements required for effective manual breast examination with women who have functional limitations and to incorporate those procedures into the MammaCare Clinical Learning System. MammaCare is a validated, skill-based training program and is a recognized standard for teaching clinicians how to conduct proficient CBE. In this Phase I research project, women representing a range of physical disabilities will be given CBEs by nurses or physicians who are MammaCare Specialist trainees using an experimental video protocol developed by participants, project staff, and consultants. The project is designed to determine whether the experimental training protocol produces proficient clinical breast examination with women who have physical disabilities, If successful, this project has the potential to improve breast cancer screening for many of the 16 million American women whose access to CBE is limited. PROPOSED COMMERCIAL APPLICATION: A validated, skill-based system for clinical breast examination of physically disabled women could fill a training gap for nurses and physicians in thousands of U.S. medical schools, nursing schools, public and private clinics, and breast centers.